Body temperature, pulse, respiration and blood pressure. These are the four primary vital signs used by doctors and nurses to measure your body’s most basic functions and detect life-threatening medical problems.

Or at least they were until 2001, when the Joint Commission dubbed pain “the fifth vital sign.” The designation was the result of a years-long push by some medical professionals and the pharmaceutical industry to do more about patients’ pain.

“There was a growing narrative that we perhaps shouldn’t allow people to suffer unnecessarily when wonderful medications were available to treat pain,” said Dr. Maja Jurisic, Vice President, Medical Director of Strategic Accounts, Concentra Occupational Health.

“It became standard of care to ask patients to rate their pain on a scale of 0 to 10.”

The practice of rating pain at every medical appointment has created the misconception that pain is inherently linked with the status of recovery from an injury. But it’s understood now that the experience of pain can be separate from the strains, sprains, breaks and tears that constitute the injury itself.